Pharmacy students' views and experiences regarding an online video-recorded objective structured clinical examination.

Objective structured clinical examinations (OSCEs) are considered gold standard in the assessment of pharmacy students' clinical skills. The COVID-19 pandemic, however, necessitated for minimising in-person interactions and therefore more innovative approaches to OSCE delivery. The objective of this study was to provide pharmacy students the opportunity to participate in an online video-recorded OSCE with pharmacist feedback, and thereafter assess their views and experiences regarding this initiative and reviewing the recording. Ethics approval was obtained prior to study commencement. All 3rd year pharmacy students in University College Cork, Ireland (n=68) were invited to participate in a formative video-recorded OSCE station online via Microsoft® Teams in April 2021, comprising one minute of reading time and five minutes of interaction time, followed by an individualised feedback session with a pharmacist facilitator. Participants were sent two surveys: one on the day of the OSCE and the other after receiving the video recording 7 days later. Closed-ended questions were analysed using Microsoft® Excel and free text comments underwent content analysis. Twenty-three students participated (34% of total), with 20 respondents to the first survey and 15 respondents to the second. Nearly all students enjoyed this OSCE experience (94%). Half of the students agreed that conducting the OSCE online (rather than in person) had no significant impact on their performance, whilst 75% agreed that knowing they were being recorded had no significant impact either. While most students (80%) agreed that this OSCE has prepared them for telepharmacy interactions in future, 25% found it difficult to get a personal connection with the simulated patient in this virtual environment. All students were satisfied with the quality of pharmacist facilitator feedback; however, 79% agreed that reviewing the recording had a significantly greater impact on them compared to receiving the facilitator feedback alone, and allowed them to become more aware of their body language during patient interactions. Whilst some students found it uncomfortable to watch the recording, 93% agreed (i) that reviewing their performance on video made them more self-aware of what clinical skills need development, and (ii) that they would review the video to help prepare for OSCEs in future. To our knowledge, this is the first study to evaluate pharmacy students' views and experiences with a formative online video-recorded OSCE with individualised feedback. This research has shown that conducting a formative OSCE online is acceptable, enjoyable, and beneficial for pharmacy students, and should be considered where in-person interactions are not possible. Furthermore, this has emphasised the added value of providing a video recording after the OSCE to heighten pharmacy students' awareness of their non-verbal communication and enhance their clinical skills. Future studies with larger sample sizes should explore how student characteristics impact on their views with such video-recorded OSCEs

Quantifying the physical activity energy expenditure of commuters using a combination of global positioning system and combined heart rate and movement sensors.

BACKGROUND: Active commuting may help to increase adults' physical activity levels. However, estimates of its energy cost are derived from a small number of studies which are laboratory-based or use self-reported measures. METHODS: Adults working in Cambridge (UK) recruited through a predominantly workplace-based strategy wore combined heart rate and movement sensors and global positioning system (GPS) devices for one week, and completed synchronous day-by-day travel diaries in 2010 and 2011. Commuting journeys were delineated using GPS data, and metabolic intensity (standard metabolic equivalents; MET) was derived and compared between journey types using mixed-effects linear regression. RESULTS: 182 commuting journeys were included in the analysis. Median intensity was 1.28 MET for car journeys; 1.67 MET for bus journeys; 4.61 MET for walking journeys; 6.44 MET for cycling journeys; 1.78 MET for journeys made by car in combination with walking; and 2.21 MET for journeys made by car in combination with cycling. The value for journeys made solely by car was significantly lower than those for all other journey types (p<0.04). On average, 20% of the duration of journeys incorporating any active travel (equating to 8 min) was spent in moderate-to-vigorous physical activity (MVPA). CONCLUSIONS: We have demonstrated how GPS and activity data from a free-living sample can be used simultaneously to provide objective estimates of commuting energy expenditure. On average, incorporating walking or cycling into longer journeys provided over half the weekly recommended activity levels from the commute alone. This may be an efficient way of achieving physical activity guidelines and improving population health.JP is supported by an NIHR post-doctoral fellowship [2012-05-157] and SC, DO and SB are supported by the Medical Research Council [Unit Programme numbers MC_UU12015/6 and MC_UU_12015/3]. The Commuting and Health in Cambridge study was developed by David Ogilvie, Simon Griffin, Andy Jones and Roger Mackett and initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study is now funded by the National Institute for Health Research Public Health Research programme (project number 09/3001/06).This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.ypmed.2015.09.02

Sunshine, Sea, and Season of Birth: MS Incidence in Wales

Maternal sun exposure in gestation and throughout the lifetime is necessary for vitamin D synthesis, and living near the sea is a population level index of seafood consumption. The aim of this study was to estimate the incidence rate of multiple sclerosis (MS) in Wales and examine its association with sun exposure, coastal living, and latitude. The study used a database of MS hospital visits and admissions in Wales between 2002 and 2013. For the 1,909 lower layer super output areas (LSOAs) in Wales, coastal status, population, longitude/latitude, and average sunshine hours per day were obtained. Age-specific and age-standardised MS incidence were calculated and modelled using Poisson regression. The distribution of births by month was compared between MS cases and the combined England and Wales population. There were 3,557 new MS cases between 2002 and 2013, with an average annual incidence of 8.14 (95% CI: 7.69-8.59) among males and 12.97 (95% CI: 12.44-13.50) among females per 100,000 population. The female-to-male ratio was 1.86:1. For both sexes combined, the average annual incidence rate was 9.10 (95% CI: 8.80-9.40). All figures are age-standardized to the 1976 European standard population. Compared to the combined England and Wales population, more people with MS were born in April, observed-to-expected ratio: 1.21 (95% CI: 1.08-1.36). MS incidence varied directly with latitude and inversely with sunshine hours. Proximity to the coast was associated with lower MS incidence only in easterly areas. This study shows that MS incidence rate in Wales is comparable to the rate in Scotland and is associated with environmental factors that probably represent levels of vitamin D

Using positive behavioural support as a treatment for trauma symptoms with a man with intellectual disabilities

Background. There is robust evidence that psychological therapies are an effective treatment for trauma-related symptoms, including post-traumatic stress disorder. However, there are relatively few studies involving people with intellectual disabilities, and no studies drawing on positive behavioural support as the mechanism for the delivery of treatment. Method and materials. This study was a descriptive case report of a young man with intellectual disabilities who had a history of early trauma. His challenging behaviour was associated with demand avoidance. A positive behavioural support plan, incorporating psychological therapies and medication, was developed, implemented and is described. Results. Over time, challenging behaviours reduced and were eventually extinguished. This was associated with an increase in engagement in a variety of activities and a reduction in trauma-related symptoms. Discussion. Using positive behaviour support plans as the organisational framework for the adaptation and delivery of both psychological therapies and medication for complex cases is advantageous. Excellent team working is necessary to ensure that interventions are successful

Are sexual media exposure, parental restrictions on media use and co-viewing TV and DVDs with parents and friends associated with teenagers' early sexual behaviour?

Sexual content in teenagers' media diets is known to predict early sexual behaviour. Research on sexual content has not allowed for the social context of media use, which may affect selection and processing of content. This study investigated whether sexual media content and/or contextual factors (co-viewing, parental media restrictions) were associated with early sexual behaviour using 2251 14–15 year-olds from Scotland, UK. A third (&lt;i&gt;n&lt;/i&gt; = 733) reported sexual intercourse. In multivariable analysis the likelihood of intercourse was lower with parental restriction of sexual media and same-sex peer co-viewing; but higher with mixed-sex peer co-viewing. Parental co-viewing, other parental restrictions on media and sexual film content exposure were not associated with intercourse. Findings suggest the context of media use may influence early sexual behaviour. Specific parental restrictions on sexual media may offer more protection against early sex than other restrictions or parental co-viewing. Further research is required to establish causal mechanisms

Gr1int/high Cells Dominate the Early Phagocyte Response to Mycobacterial Lung Infection in Mice

Lung infection by Mycobacterium tuberculosis is characterized by chronic infection of lung-resident macrophages, long considered to be the primary hosts and determinants of the outcome of the early immune response. Although alveolar macrophages are well-known to host intracellular mycobacteria at later stages of disease, little is known about the earliest events of the innate immune response. The phagocytes that take up mycobacteria immediately following infection, and how the early lung phagocyte response is altered by vaccination with M. bovis bacille Calmette-Guérin (BCG) were unknown. Using BCG expressing the bright red fluorescent protein tdTomato and flow cytometry, we modeled early infection in C57BL/6 mice and tracked phagocyte population kinetics and uptake of mycobacteria, to better understand the involvement of specific phagocyte subsets. By 1 day post-infection, dose-dependent accumulation of neutrophils was observed and surprisingly, granulocytes comprised a greater proportion of infected phagocytes than alveolar macrophages. By 7 days post-infection alveolar macrophages had become the dominant BCG-associated phagocytes. Prior mucosal BCG exposure provided immunized mice with greater frequencies and numbers of lung macrophage subsets, and a significantly greater proportion of alveolar macrophages expressed CD11b prior to and following challenge infection. These data provide the first evidence of granulocytes as the dominant infected phagocyte subset early after mycobacterial infection, and highlight enhanced recruitment of lung macrophages as a factor associated with protection in BCG-immunized mice

Novel Selective Agents for the Degradation of Androgen Receptor Variants to Treat Castration-Resistant Prostate Cancer

Acknowledgements: The authors thank Mr. Maron Lee Barrett and Ms. Mayra Star for their technical help. The authors thank Dr. Dejian Ma for his technical help with the NMR studies. The authors thank the UTHSC and St. Jude NMR core for their help with the NMR studies. The authors thank Drs. Robert Getzenberg and Michael Mohler for providing useful comments on the manuscript. The authors thank Ms. Brandy Grimes for her help with tissue procurement. The authors thank Dr. Daniel Johnson of UT BioCore for microarray data analysis and Mr. Lorne Rose of UT-MRC core for microarray studies. Funding Source: The research presented in this manuscript was supported by a research funding provided by GTx, Inc. Memphis, TN to R. Narayanan and by a research funding provided by West Cancer Center to R. Narayanan.Peer reviewedPostprin